Ethiopia's nutritional crisis: the pick is over but the future remains uncertain

The worse of the nutritional crisis that hit extensive areas of the southern regions of Oromiya and SNNP (Southern Nations and Nationalities People) in Ethiopia last spring seems to have passed, although there remain some isolated malnutrition hotspots.

Patient admission numbers have steadily decreased in the majority of MSF's nutritional programmes in the southern regions, some of which are now in the process of closing. However, in certain areas, particularly Gedo and Bursa Districts of SNNPR, the situation remains critical; a few hundred severely malnourished patients continue to arrive at our nutritional centres each week.

Elsewhere in the country, specifically in parts of the crisis-affected area of the Somali region, malnutrition remains a concern. The number of admissions to MSF's therapeutic feeding program in Wardher town has significantly increased over the past month. 

In Gedeo an average of 350 new cases per week

"3,000 severely malnourished children have been admitted to our programme in Gedeo district, in ten weeks," said Dounia DEKHILI, MSF coordinator. "In this densely populated area, food distribution has remained very limited in the past months; people have only cabbages to eat or else so-called "false bananas", the most common Ethiopian root crop which has poor nutritional value. Most people make their livelihood from coffee production but the harvest is just beginning and people are worried because they say part of the production has been destroyed by parasites or  heavy rains."

Nutritional activities are also continuing in Bursa district, where the intervention began in the middle of August, but there has been a progressive decline in the numbers of admissions of severe cases of malnutrition with less than 100 per week for the last month.

In Kindo Didaye district, MSF activities closed at the end of November after donations of medical material and staff training were made available to the Ministry of Health facilities.

In Kambata district the programmes closed at the end of November; less than 30 patients were under ambulatory treatment and were transferred to ambulatory health posts. An additional five cases which were more serious were transferred to a private clinic nearby. The situation in terms of food security seems to have improved but the future months remain uncertain.

At the end of November, MSF had treated more than 24,700 severely malnourished children and 24,300 moderately malnourished children in its health facilities in the SNNP region

In Oromiya the food situation has improved

MSF activities also ended in the Oromiya region at this time. In Shashemene and Shalla, patients were transferred to the existing facilities nearby; four severely malnourished patients were brought to the Kuyera Hospital. In all, MSF treated 7,538 severely malnourished patients and 13,312 moderate cases in this region.

The intervention launched in Siraro in early May ended by mid-September, once MSF teams had treated 2,600 severely malnourished patients; remaining patients were transferred to the local health authorities. In addition, the team carried out a targeted feeding program for 14,000 children at risk.

The recent controls carried out by our medical teams on the food situation in these areas have shown very low levels of malnutrition; for the moment the situation in terms of harvest food availability seems promising.

Still malnutrition in other regions

In August, MSF launched a nutritional intervention in Afar region, an isolated area in the north east of the country, after a survey showed alarming malnutrition rates. By the end of November, 800 severely malnourished patients had been treated in the MSF programme. The intervention will continue until March 2009, the end of the hunger gap in the area.

In the crisis affected area of the Somali region malnutrition remains a concern in some of the areas where MSF works. The number of admissions to MSF's therapeutic feeding program in Wardher town has significantly increased over the past month. We currently have more than 400 severely malnourished children in our therapeutic feeding centre. In Degahbur, MSF has treated this year more than 1,500 severely malnourished children and close to 3,000 moderately malnourished. In the last month, the team has seen an increase of admissions in the programmes. There are currently 470 severely malnourished and 730 moderately malnourished in the programme.

MSF nutritional programmes

Patients in the programme for severe malnutrition receive weekly medical consultations and ready to use therapeutic food which is full of calories and essential micronutrients. They put on weight and their bodies regain the strength to fight infections. MSF teams also distribute rations of cereal and oil for the families. MSF set up also hospitalization units for children needing closer medical care. This combination of medical care, therapeutic food and food rations has proved successful in mere weeks, with more than nine out of ten children recovering. 

Moderately malnourished people receive 25 kilos of enriched flour and 5 litres of oil for a month in addition to medical care when and as needed. Huge amounts of food have been distributed by MSF teams in the last months in an effort to limit the occurrence of new and severe malnutrition cases. In most areas a decrease in the number of admissions for severe malnutrition has followed the distribution of food.